有氧运动联合常规康复治疗对卒中偏瘫患者心肺运动功能及康复效果的影响

发布时间：2018-08-30 08:07

【摘要】：目的探讨有氧运动联合常规康复治疗对卒中偏瘫患者心肺运动功能及康复效果的影响。方法前瞻性连续纳入30例首次发病的卒中偏瘫患者,按随机数字表法随机分为试验组和对照组,每组15例。4例患者退出,最终26例患者完成研究,每组13例,两组患者均给予常规康复治疗,试验组在常规康复治疗基础上增加有氧运动训练,每天1次,每次30 min,共训练4周。分别于治疗前和治疗4周后对两组患者进行心肺运动试验[峰值摄氧量(VO2peak)、无氧阈(AT)、峰值分钟通气量(VEpeak)]以及运动功能[Fugl-Meyer评定量表(FMA)]、日常生活活动能力[Barthel指数(BI)]的评估,比较两组患者治疗前后的差异。结果 (1)心肺运动试验结果:与治疗前比较,试验组患者治疗后VO2peak、AT、VEpeak均明显提高[分别为(16±4)ml/(kg·min)比(13±3)ml/(kg·min)、(12.9±2.5)ml/(kg·min)比(10.0±2.7)ml/(kg·min)、(41±12)L/min比(34±9)L/min;t值分别为9.668、4.328、3.662,均P0.01],对照组患者治疗后与治疗前VO2peak、AT、VEpeak比较[分别为(14±4)ml/(kg·min)比(14±4)ml/(kg·min)、(11.8±2.6)ml/(kg·min)比(11.5±2.9)ml/(kg·min)、(29±8)L/min比(28±6)L/min],差异无统计学意义(t值分别为0.863、0.583、0.314,均P0.05);对照组患者治疗前后VO2peak、AT、VEpeak差值分别为0.4(0.2,0.6)、0.1(-0.5,0.7)ml/(kg·min)和0(-2.5,5.0)L/min,试验组患者治疗前后VO2peak、AT、VEpeak差值分别为3.0(2.2,3.9)ml/(kg·min)、2.7(1.8,5.3)ml/(kg·min)、7.0(1.0,13.0)L/min,两组间治疗前后VO2peak、AT、VEpeak差值差异有统计学意义(Z值分别为4.287、3.721、2.236,均P0.05)。(2)FMA评分与BI评估结果:与治疗前比较,试验组患者治疗后FMA评分、BI均明显提高[分别为(70±24)分比(52±28)分、(78±20)比(60±28);t值分别为4.076,4.239,均P0.01],对照组治疗后FMA评分、BI较治疗前有明显改善[分别为(68±25)分比(60±27)分、(69±22)比(59±26);t值分别为3.168,5.436,均P0.05]。对照组治疗前后FMA评分、BI差值分别为5.0(2.0,12.0)分、10.0(5.0,15.0),试验组治疗前后FMA评分、BI差值分别为10.0(4.5,32.0)分、11.0(10.0,27.5),组间差异无统计学意义(Z值分别为1.393、1.352,均P0.05)。结论卒中偏瘫患者在常规康复治疗基础上,增加有氧运动训练,能够提高其心肺运动功能。
[Abstract]:Objective to investigate the effects of aerobic exercise combined with routine rehabilitation therapy on cardiopulmonary motor function and rehabilitation in stroke hemiplegic patients. Methods Thirty first-time stroke hemiplegia patients were prospectively enrolled and randomly divided into experimental group (n = 15) and control group (n = 13). 15 patients in each group withdrew from the study, and 26 patients in each group, 13 patients in each group, were enrolled in the study. The patients in both groups were given routine rehabilitation therapy. Aerobic exercise training was added to the routine rehabilitation treatment in the experimental group for 4 weeks, once a day for 30 min,. Cardiopulmonary exercise test [peak oxygen uptake (VO2peak), anaerobic threshold (AT), peak minute ventilation volume (VEpeak)], motor function [Fugl-Meyer rating scale (FMA)] and activity of daily living [Barthel index (BI)] were evaluated before and 4 weeks after treatment, respectively. To compare the difference between the two groups before and after treatment. Results (1) the results of cardiopulmonary exercise test were compared with those before treatment. 璇曢獙缁勬偅鑰呮不鐤楀悗VO2peak,AT,VEpeak鍧囨槑鏄炬彁楂榌鍒嗗埆涓，

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